Analysis, capturing and transfer of referenceable individual patient information

WHEN IT COMES TO HEALING ... ... only the best is good enough. For this reason, we decided to work with my long-time colleague, Udo Plaster, MDT, in the realm of patient and model analysis. His PlaneSystem® is a transfer method that respects and recognises the patient as a person. Whether we choose the digital or the traditional route in the preparation of dental restorations, the accurate and individual recording of patient data by the PlaneSystem® will pave the way for the pursuit of complete health. We have integrated the PlaneSystem® working with Udo on new ideas and improvements.

PREFACE As with a compass, the individual circumstances also determine the solution approach, e.g. within the framework of a complete prosthetic restoration. The digital technologies offer us fascinating This reproducibility offers a high degree of safety for complex therapies. PRESENTATION OF THE PATIENT CASE The prosthetic rehabilitation of a patient who has been suffering from severe physical complaints for years is presented here. Based on a dental diagnosis and a dental technical analysis, the reason for the planes with the PlaneSystem® (Zirkonzahn) and anatomical orientation points, the...

“I’VE BEEN SUFFERING FROM HEADACHES AND STRONG TENSIONS IN THE NECK AREA FOR A LONG TIME. THIS SITUATION RESTRICTS ME VERY MUCH IN THE SOCIAL EVERYDAY LIFE. I’M JUST FEELING UNCOMFORTABLE AND FINALLY WANT SOME RELIEF FROM THE DISCOMFORT.

OVERVIEW OF THE COURSE OF TREATMENT 1. Analysis & diagnostics 2. Prototype 1 (maxilla), table-tops (mandible) 3. Planning of the dental restoration and implantation 4. Prototype 2 (long-term provisional in the maxilla) and second therapeutic phase 5. Prototype (lower jaw) 6. 2006 – 2013: SEVEN YEARS OF WHOLEBODY DISCOMFORT The patient has been suffering for years from severe tension in the neck area and chronic headaches. Physiotherapeutic treatments were not successful.

The change of her physiotherapist in 2013 “got the ball rolling”. Dysfunctional dentures are suspected to be the cause of the complaints. In coordination with the physiotherapist, the dentist and the dental technician, a comprehensive diagnostics has been carried out. FIRST DENTAL TECHNICAL ANALYSIS (2013) - Conversation regarding the dental history Analysis of the face and the model Checking the speech motor skills Analysis of the existing dental restoration

DENTAL HISTORY (YEAR 2006) The patient is provided with a removable telescopic work in the maxilla. Four implants, a screw (21) and a root-treated tooth (15) are visible in the upper jaw. Six implants (SPI® Element, Thommen Medical) are inserted and healed in in the lower jaw. After creating an implant impression, the dental technician* at the time fabricated individual abutments (at the same time primary parts) and a double crown prosthesis. The existing restoration in the upper jaw is reworked accordingly. * not the author of the brochure

ANALYSIS AND THERAPEUTIC PROTOTYPE | 2013 ANALYSIS: CEPHALOGRAM The lateral cephalogram reveals that the dental restoration is not functionally correct contact in the molar region, but predominantly on the anterior teeth. ANALYSIS: OCCLUSAL PLANE AND REQUEST OF THE PATIENT First analysis of the digitised models; the occlusal plane does not correspond to the physiological conditions. To compensate for this, the patient is “pushed” into a physical malposition. In addition to freedom from symptoms, the patient hopes that the new dental prosthesis will also correct the sunken upper lip.

ANALYSIS: ALA-TRAGUS PLANE To what extent does the occlusal plane of the denture deviate from the physiological situation? The answer results from a measurement for which a zero line serves as reference. + 7° The patient positions herself in the Natural Head Position. The image from a lateral view with the situation model shown (maxilla) illustrates the deviation between the ala-tragus line* (green) and the current occlusal plane (black). The difference is 11°. * Ala-tragus line = connecting line from the ala nasi (ala of the nose) to the tragus (entrance of external auditory canal) INFORMATION...

ANALYSIS AND THERAPEUTIC PROTOTYPE | 2013 ANALYSIS: EXISTING DENTAL RESTORATION Reference on the skull for the fabrication of the dental restoration (2006) at that time was the Frankfurt Plane (blue line) as an arbitrary axis. C The dental technician therefore lacked important of the planes. This could have been the reason for the incorrectly interpreted occlusal plane. REALISTIC REFERENCE? Although the positioning of the occlusal plane in relation to the Frankfurt plane in the articulator appears to be good, the realistic situation F C skull-related references, rather than skull- The situation...

ANALYSIS: NATURAL HEAD POSITION (NHP)* The NHP assesses craniofacial growth, the position of the restoration in the skull and the speaking distance. The patient’s statement that her tongue is constricted when speaking and ANALYSIS: HEAD POSTURE When testing the speech motor skills, the sagittal view shows that the patient pushes her head forward when speaking (head forward position) and “subsides” backwards when biting.

ANALYSIS AND THERAPEUTIC PROTOTYPE | 2013 ANALYSIS: CRANIOFACIAL GROWTH Every person has a strong and a weak side of the face; a normal asymmetry that must be taken into account when creating a dental restoration. In this case, the frontal view also makes it clear that the patient “subsides” when biting. The lower jaw not only balances the height vertically, but also shifts to the left. BACKGROUND INFORMATION PHYSIOTHERAPY: SEVEN COMPENSATION POINTS The body compensates for deviations in the orofacial system (e.g. due to dysfunctional dentures). This analysis is done by the physiotherapist. Seven...

AQUALIZER*: NEUTRALISATION direction. For a new restoration, the vertical dimension (VDO) must be created. A water cushion* is used to balance the lower jaw position. The height of the cushion results from Height Aqualizer: Medium Water cushion 4 mm = 2 mm occlusal distance the speaking distance and the information of the model analysis. In this case a medium-sized position and corrects the height on her own (neutralisation). ANTERIOR TOOTH JIG anterior jig at the correct height is made with registration material. After the jig has been elaborated, a point-shaped central lower incisal contact...